KELENGKAPAN PENGISIAN INFORMED CONSENT PADA PASIEN APENDEKTOMI DI RSU UKI PERIODE JANUARI 2015 - OKTOBER 2016

Informed consent is an approval of medical treatment given by the patient or the next of kin after getting a complete explanation about the medical treatment will be done. Approval or refusal of medical treatment is necessary before providing medical treatment such as appendectomy. Appendectomy also needs the patient or next of kin informed consent approval before providing the treatment, but in reality, the implementation of filling informed consent at the hospital sometimes not in accordance with existing regulations. The purpose of this study is to determine the completeness of filling informed consent in patients undergo appendectomy at RSU UKI from January 2015-October 2016. This study used a descriptive research with document study design and 129 data meets the inclusion criteria is obtained. Instrument used are medical records from patients undergo appendectomy at RSU UKI Jakarta. The results is from 129 data with 30 items examined, only 3 items filled completely (100%), which is the identity of the person giving approval, the signature of the person giving approval, and the signature of the surgery operator. The other 27 items is not completely filled. The conclusion is the completeness of filling informed consent in patients undergo appendectomy at RSU UKI is low. Keywords: completeness of informed consent, Appendectom

Identification of Seasonal Variations of Antibodies against PR-10-Specific Epitopes Can Be Improved Using Peptide-Phage Display

Background: In pollinosis patients, allergen-specific antibody titers show seasonal variations. Little is known about these variations at the epitope level. Objectives: We aimed at investigating seasonal variations on the level of allergen epitope recognition in patients with Bet v 1-related food allergy using a peptide phage display approach. Methods: Serum samples collected over 1 year from 4 patients of the placebo arm of the birch-associated soya allergy immunotherapy trial were included. To identify epitopes from Bet v 1-related food allergens, patient sera were used in peptide phage display experiments. In silico analysis of enriched allergen-related motifs was performed. Results: We identified epitope motifs related to Bet v 1 and its homologs in soya and hazelnut (Gly m 4 and Cor a 1, respectively) that were enriched in accordance with birch and hazel pollen exposure. Within several weeks after the birch pollen season peak, the pattern of identified epitope motifs differed considerably among patients. Data for amino acid preferences in homologous Bet v 1 and Cor a 1 epitope motifs identified for one of the investigated patients suggest changes in concentration or specificity of serum antibodies for the Cor a 1 epitope motif. Conclusions: Peptide phage display data suggest an impact of birch and hazel pollen exposure on the recognition pattern of Bet v 1-like allergen epitopes. Epitope-oriented analyses could provide deeper, personalized details regarding the allergen epitope recognition influenced by pollen exposure beyond the capability of current method

Photophysics, Molecular Reorientation in Solution and X-Ray Structure of a New Fluorescent Probe 1,7-Diazaperylene

A new fluorescent molecule 1,7-diazaperylene (DP) has been investigated by means of time-resolved and steady-state polarized fluorescence spectroscopy, as well as X-ray spectroscopy. Absorption and fluorescence spectra of DP in solution are similar to those of perylene. However, absorption and fluorescence spectra of 2,8-dimethoxy DP and 2,8-dipentyloxy DP in solution are red-shifted by ca. 55 nm relative to perylene. The fluorescence decay of DP is exponential with a lifetime of 5.1 ns in ethanol, 4.9 ns in glycerol and 4.3 ns in paraffin oil. The radiative lifetime in ethanol was calculated to be 6.3 ns for DP, 8.0 ns for 2,8-dimethoxy DP and 7.6 ns for 2,8-dipentyloxy DP. The calculated fluorescence quantum yields of 0.8 for DP and its alkoxy derivatives in ethanol, are in good agreement with those obtained from measurements. The calculated Förster radius is 37.2 ± 1 Å for DP and 41.9 ± 1 Å for its alkoxy derivatives in ethanol. Examining the S0 S1 transition, we obtain a limiting fluorescence anisotropy of r0 0.38 for DP and its alkoxy derivatives. The rotational rates of DP in paraffin oil and glycerol were compared to that of perylene. In paraffin oil both molecules show an almost identical biexponential decay of the fluorescence anisotropy, which is compatible with a rotational motion like an oblate ellipsoid. The fluorescence anisotropy is monoexponential for DP in glycerol, and DP appears to rotate like a spherical particle while perylene in glycerol appears to rotate like an oblate ellipsoid. Moreover, the rotational diffusion constant, corresponding to rotation about an axis in the aromatic plane (D), is the same for both DP and perylene in glycerol

Integrin αE(CD103) Is Involved in Regulatory T-Cell Function in Allergic Contact Hypersensitivity

Murine contact hypersensitivity (CHS) is a dendritic cell (DC)-dependent T-cell-mediated inflammation with CD8+ T cells as effectors and CD4+ T cells as regulators (Treg cells) that models human allergic contact dermatitis. The integrin αE(CD103) is expressed by some T-cell and DC subsets and has been implicated in epithelial lymphocyte localization, but its role in immune regulation remains enigmatic. We have identified a function for CD103 in the development of cutaneous allergic immune responses. CHS responses, but not irritant contact dermatitis, were significantly augmented in CD103-deficient mice in hapten-challenged skin. Phenotype and function of skin DCs during sensitization were normal, whereas adoptive transfer experiments revealed that the elevated CHS response in CD103-deficient mice is transferred by primed T cells and is independent of resident cells in recipient mice. While T-cell counts were elevated in challenged skin of CD103-deficient mice, the FoxP3 expression level of CD4+CD25+ Treg cells was significantly reduced, indicating impaired functionality. Indeed, Treg cells from CD103-deficient mice were not able to suppress CHS reactions during the elicitation phase. Further, CD103 on FoxP3+ Treg cells was involved in Treg retention to inflamed skin. These findings indicate an unexpected dichotomous functional role for CD103 on Treg cells by modulating FoxP3 expression

Can Urban Air Mobility become reality? Opportunities, challenges and selected research results

Urban Air Mobility (UAM) is a new air transportation system for passengers and cargo in urban environments, enabled by new technologies and integrated into multimodal transportation systems. The vision of UAM comprises the mass use in urban and suburban environments, complementing existing transportation systems and contributing to the decarbonization of the transport sector. Initial attempts to create a market for urban air transportation in the last century failed due to lack of profitability and community acceptance. Technological advances in numerous fields over the past few decades have led to a renewed interest in urban air transportation. UAM is expected to benefit users and to also have a positive impact on the economy by creating new markets and employment opportunities for manufacturing and operation of UAM vehicles and the construction of related ground infrastructure. However, there are also concerns about noise, safety and security, privacy and environmental impacts. Therefore, the UAM system needs to be designed carefully to become safe, affordable, accessible, environmentally friendly, economically viable and thus sustainable. This paper provides an overview of selected key research topics related to UAM and how the German Aerospace Center (DLR) contributed to this research in the project "HorizonUAM - Urban Air Mobility Research at the German Aerospace Center (DLR)". Selected research results that support the realization of the UAM vision are briefly presented.Comment: 20 pages, 7 figures, project HorizonUA

A Collaborative Systems of Systems Simulation of Urban Air Mobility: Architecture Process and Demonstration of Capabilities

Urban Air Mobility (UAM) presents a complex challenge in aviation due to the high degree of innovation required across multiple domains to realize it. From the use of advanced aircraft powered by new technologies, the management of the urban air space to enable high density operations, to the operation of specialized vertidromes serving as a start and end point of the vehicles, the UAM paradigm necessitates a significant departure from aviation as we know it today. In order to understand and assess the many facets of this new paradigm, a Collaborative Agent-Based Simulation is developed to holistically evaluate the system through the modelling of the stakeholders. In this regard, models of vertidrome air-side operations, urban air space management, passenger demand estimation and mode choice, vehicle operator cost and revenues, vehicle maintenance, vehicle allocation, fleet management based on vehicle design performance and mission planning are brought together into a single Collaborative System of Systems Agent-Based Simulation of Urban Air Mobility. Through collaboration, higher fidelity models of each domain can be brought together into a single environment which can then be exploited by all partners, achieving comprehensiveness and fidelity levels not achievable by a single partner. Furthermore, the integration enables the capture of cross-domain effects with ease and allows the domain-specific studies to be evaluated at a holistic level. Agent-Based Simulations were chosen for this collaborative effort as it presents a suitable platform for the modelling of the stakeholders and interactions in accordance with the envisioned concept of operations. This work presents the capabilities of the developed Collaborative System of Systems Agent-based Simulation, the development process and finally a visual demonstration. The objectives of this presentation are: • Detail the development process of the Collaborative System of Systems Agent-Based Simulation • Demonstrate a holistic simulation of UAM built through collaboration of multiple tools/modules such as vertiport and trajectorie

Tracking CNS and systemic sources of oxidative stress during the course of chronic neuroinflammation

The functional dynamics and cellular sources of oxidative stress are central to understanding MS pathogenesis but remain elusive, due to the lack of appropriate detection methods. Here we employ NAD(P)H fluorescence lifetime imaging to detect functional NADPH oxidases (NOX enzymes) in vivo to identify inflammatory monocytes, activated microglia, and astrocytes expressing NOX1 as major cellular sources of oxidative stress in the central nervous system of mice affected by experimental autoimmune encephalomyelitis (EAE). This directly affects neuronal function in vivo, indicated by sustained elevated neuronal calcium. The systemic involvement of oxidative stress is mirrored by overactivation of NOX enzymes in peripheral CD11b(+) cells in later phases of both MS and EAE. This effect is antagonized by systemic intake of the NOX inhibitor and anti-oxidant epigallocatechin-3-gallate. Together, this persistent hyper-activation of oxidative enzymes suggests an "oxidative stress memory" both in the periphery and CNS compartments, in chronic neuroinflammation

A Multisite Preregistered Paradigmatic Test of the Ego-Depletion Effect

We conducted a preregistered multilaboratory project (k = 36; N = 3,531) to assess the size and robustness of ego-depletion effects using a novel replication method, termed the paradigmatic replication approach. Each laboratory implemented one of two procedures that was intended to manipulate self-control and tested performance on a subsequent measure of self-control. Confirmatory tests found a nonsignificant result (d = 0.06). Confirmatory Bayesian meta-analyses using an informed-prior hypothesis (δ = 0.30, SD = 0.15) found that the data were 4 times more likely under the null than the alternative hypothesis. Hence, preregistered analyses did not find evidence for a depletion effect. Exploratory analyses on the full sample (i.e., ignoring exclusion criteria) found a statistically significant effect (d = 0.08); Bayesian analyses showed that the data were about equally likely under the null and informed-prior hypotheses. Exploratory moderator tests suggested that the depletion effect was larger for participants who reported more fatigue but was not moderated by trait self-control, willpower beliefs, or action orientation.</p